<!-- INCLUDE overall_header.html -->

<form action="{U_REPORTLOST}" method="post" id="remind">

<div class="panel">
	<div class="inner"><span class="corners-top"><span></span></span>

	<div class="content">
		<h2>{L_YUBIKEY_REPORT_LOST}</h2>

		<fieldset>
		<dl>
			<dt><label for="username">{L_USERNAME}:</label></dt>
			<dd><input type="text" tabindex="1" name="username" id="username" size="25" class="inputbox narrow" /></dd>
		</dl>
		<dl>
			<dt><label for="email">{L_EMAIL_ADDRESS}:</label><br /><span>{L_EMAIL_REMIND}</span></dt>
			<dd><input type="text" tabindex="2" name="email" id="email" size="25" maxlength="100" class="inputbox narrow" /></dd>
		</dl>
		<dl>
			<dt>&nbsp;</dt>
			<dd>{S_HIDDEN_FIELDS}<input type="submit" tabindex="3" name="submit" id="submit" class="button1" value="{L_YUBIKEY_REPORT_LOST}" tabindex="2" />&nbsp; <input type="reset" tabindex="4" value="{L_RESET}" name="reset" class="button2" /></dd>
		</dl>
		{S_FORM_TOKEN}
		</fieldset>
	</div>

	<span class="corners-bottom"><span></span></span></div>
</div>
</form>

<!-- INCLUDE overall_footer.html -->